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WHAT’S HAPPENING 

The Academy Hosts Global Leadership Session

Participants from the 13th class of the Academy’s Leadership Development Program (LDP) joined Eye M.D.s from equivalent international programs—the Pan-American Association of Ophthalmology’s (PAAO) Curso de Liderazgo and the European Society of Ophthalmology’s (SOE) EuLDP—during a series of interactive sessions from January 14 to 16 in San Francisco.

Participants from the three organizations took part in sessions covering a range of topics, including effective negotiation tactics, media skills, running effective meetings, avoiding conflicts of interest, and patient advocacy. “The interactive, role-playing seminars are so much fun and beneficial,” said LDP participant Gary S. Hirshfield, MD. “I really value the opportunity of meeting the participants from the LDP and the PAAO Curso,” added EuLDP participant Gauti Johannesson, MD.

Part of the program included a visit to the Academy’s headquarters to learn about the history of the organization and to hear from Academy President Richard L. Abbott, MD, and Academy Executive Vice President and CEO David W. Parke II, MD. “This has been a fantastic opportunity to interact with Academy leadership who are so engaging,” said LDP participant Romona Davis, MD. “And the level of energy that each participant shares with our group has inspired me to seek new opportunities in my state.”

Participants in the Academy’s year-long program were nominated by state, subspecialty and specialized interest societies. Similarly, PAAO Curso and SOE EuLDP participants were nominated by national Latin American and European societies. PAAO’s Curso has the same yearlong commitment as the Academy’s LDP while SOE’s EuLDP is a two-year program. Leadership program directors are all graduates of these programs and include Academy LDP director David W. Johnson, MD, PAAO Curso director Zélia M. Corrêa, MD, PhD, and SOE EuLDP director Nikos Bechrakis, MD.

For more information about these leadership development programs, contact Gail Schmidt at gschmidt@aao.org.

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TAKE NOTICE 

Ask the Ethicist: Wrong IOL Power

By the Ethics Committee

Q: During a routine cataract surgery postoperative visit, my patient expressed concern about suboptimal visual acuity. I discovered that a wrong-power IOL was used in the patient’s surgery. This error occurred during surgery prep; the correct IOL power was noted in the patient’s preoperative notes. How should I inform my patient that the wrong lens was used without losing her trust in my abilities or bringing on potential litigation?

A: Experts agree that if the wrong IOL is placed, ophthalmologists should tell patients the truth promptly in a detailed, open discussion and give an apology. Patients should actively participate in the discussion about methods to resolve the problem. Open and honest communication engenders trust, and including the patient in the resolution process strengthens that trust. The ophthalmologist should also waive any fees associated with replacing the lens.

Few medical errors have received as much attention as wrong-site surgery, which, in ophthalmology, includes wrong IOL power. The Ophthalmic Mutual Insurance Company has reported that the majority of wrong-site allegations—those considered completely preventable by juries and plaintiff attorneys—involved claims of wrong-power IOLs. The best cure for mistakes is prevention. Preoperative verification processes such as marking the eye and a presurgery time-out are recommended to prevent site errors and are standard in the profession. It is important to include a step in your time-out procedure to verify the IOL power to be used.

Common reasons for using the wrong IOL power include patients being out of order in the surgical queue, changing the IOL power intraoperatively, documentation errors, patients with the same last name having surgery on the same day and inputting incorrect data into the IOL calculators.

Claims experience has shown that a good physician-patient relationship depends on compassionate, timely and factual communication. When these components are missing and the patient is informed that they may be at risk for other problems, patients lose faith in their surgeons and often seek a second opinion or legal advice.

For more information or to submit a question for this column, contact the Ethics Committee staff at ethics@aao.org. To read the Code of Ethics, visit www.aao.org/about and click “Ethics” and “Code of Ethics.”

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Should You Adopt EHR Now or Wait?

Incentives are available for ophthalmologists who become meaningful users of EHR between 2011 and 2014 (amounts vary by year). Ophthalmologists who have not become meaningful users by 2015 will be penalized.

When is the ideal time to adopt EHR? The Academy and AAOE have developed “Evaluating the Pros and Cons of EHR Adoption” to help you decide.

To access this resource, visit www.aao.org/ehr and select “Planning and Selection,” “Define Your Goals” and “Pros and Cons of EHR Adoption.”

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Now Accepting Data for Ophthalmology’s Largest Survey of Practices

Data from fiscal year 2010 are now being accepted for this year’s Academy/AAOE benchmarking survey. Last year, 216 practices participated, resulting in the largest sample of ophthalmology practice data available.

A key feature of the resulting database is the ability to filter data by subspecialty, number of physicians, region and local population. Monitoring your practice revenue, costs and overall productivity in comparison with similar practices is especially vital now as reimbursements decline and practice expenses continue to climb.

Only practices that complete the survey may access the database. The deadline to participate is June 30.

For more information, visit www.aao.org/benchmarking.

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What’s New? Read the 2010 Year in Review

Find out what the Academy has achieved in the last year on all fronts, including advocacy, education, public service and more. The 2010 Year in Review is viewable on your computer, iPad, iPhone or Android and provides a quick update on:

  • how the Academy’s advocacy efforts have impacted Medicare payments, optometric scope expansion and health care reform,
     
  • new content and plans for the Ophthalmic News and Education (ONE) Network,
     
  • how your patients can benefit from the new EyeSmart website,
     
  • better ways to connect with other members on the Academy Online Community,
     
  • global humanitarian and educational outreach programs, and
     
  • what’s in store for 2011.

To access the 2010 Year in Review, visit www.aao.org/yearinreview.

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Become an Ophthalmic Coding Specialist

The online OCS Exam is the only test of coding competency in ophthalmology. This open-book exam covers a broad range of topics in 19 content areas. Those who earn a passing score will receive an OCS designation valid for three years.

The test has been awarded four JCAHPO Group A CE credits.

Anyone who passes the exam between Oct. 1, 2010, and Dec. 31, 2011, is eligible to win an iPad.

To find out about study tools, get more information or sign up to take the exam, visit www.aao.org/ocs.

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Network With Your Peers in the Online Community

Check out the Academy’s remodeled Online Community. The new design and navigation make it easier to find colleagues, while a subspecialty list allows you to jump right to the group you are looking for. The site also includes new blogs featuring commentary from ophthalmic leaders.

Visit www.aao.org/community.

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ACADEMY STORE 

Check Out These New Patient Education Brochures

Twenty-three brochures have been updated and are now available to help you save time educating your patients about eye conditions and treatments.

Titles include AMD and Nutritional Supplements; Stye and Chalazion; Eyelid Margin Disease Including Blepharitis, Pterygium and Pinguecula; and Retinal Angiography. Brochures come in packages of 100 and cost $32 for members and $40 for nonmembers.

To order, visit www.aao.org/store and click on the “New Products” button.

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Stay Up to Date and Prepare for MOC Exams

The new Practicing Ophthalmologists Learning System is a comprehensive lifelong learning program that provides a clinically relevant review of topics across all practice emphasis areas (PEAs) in ophthalmology. Use the system to keep your clinical knowledge up-to-date and prepare for maintenance of certification (MOC) exams.

This online product includes 11 PEAs as well as content filters to focus your studies on specific MOC topics. The self-assessment section provides feedback with links to supporting information and simulates the MOC online test-taking experience.

The Practicing Ophthalmologists Learning System is $495 for members and $645 for nonmembers.

To order, visit www.aao.org/store or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540.

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MEETING MATTERS 

Submit Abstracts for Papers, Posters and Videos

If you are interested in being a presenter at this year’s Annual Meeting, abstracts must be submitted online between Wednesday, March 16, and Tuesday, April 12. Be sure to review the abstract guidelines before making your submission.

For more information, go to www.aao.org/presentercentral or e-mail meetings@aao.org.

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Visit the Academy at APAO and ASCRS

If you are planning to attend the Asia Pacific Academy of Ophthalmology meeting in Sydney (March 21 to 24) or the American Society of Cataract and Refractive Surgery meeting in San Diego (March 26 to 29), stop by the Academy’s booth for the latest Academy products and get information about this year’s Academy Annual Meeting in Orlando.

For more details, visit www.aao.org/meetings/aao_exhibits.cfm.

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MEMBERS AT LARGE 

People

Jayakrishna Ambati, MD, has been selected to receive the 2011 ARVO Foundation for Eye Research/Pfizer Ophthalmics/Carl Camras Translational Research Award.  

This award is given to researchers who exhibit excellence in research through their scientific discoveries or through technologies they have developed that have already led to or may lead to clinical applications.

“I am honored and humbled to be chosen for this prestigious award,” Dr. Ambati said. “This award recognizes the important contributions that the talented young scientists in my research group have made in advancing the understanding of how macular degeneration develops and how it can be better diagnosed and treated.”

Brian P. Brooks, MD, PhD, has been named by the White House as one of the recipients of the 2010 Presidential Early Career Awards for Scientists and Engineers.

Dr. Brooks is a member of the National Eye Institute Intramural Research Program and chief of the Institute’s Unit on Pediatric, Developmental and Genetic Ophthalmology. The award recognizes Dr. Brooks for his molecular genetics research on uveal coloboma.

Ralph C. Lanciano Jr., DO, has received the Academy’s 2010 State Government Affairs Hall of Fame award for his lifelong commitment, leadership and determination in fighting for quality care and patient safety.

Dr. Lanciano is a two-term past-president of the New Jersey Academy of Ophthalmology and has served as Academy councilor for New Jersey. Dr. Lanciano also volunteers his time to lecture residents on behalf of the Academy’s Residents Advocacy Program in Philadelphia and throughout New Jersey.

The AMA has awarded Mildred M. G. Olivier, MD, with its Dr. Nathan Davis International Award in Medicine. This award recognizes physicians whose influence reaches the international patient population and changes the future of their medical care.

Dr. Olivier’s ultimate goal is to eradicate preventable blindness due to glaucoma in Haiti. She leads regular medical missions to Haiti two or three times a year, bringing medical equipment, her skills, other practitioners and training programs to local Haitian doctors. In addition, she is working with a team to identify markers for glaucoma through registration and genetic sampling of families in Haiti with high incidence of the disease.

Dr. Olivier, along with Michael Brennan, MD, Richard Lee, MD, and Stephanie Marioneaux, MD, of the Academy’s Task Force on Haiti Recovery and PAAO's Natalio Izquierdo, MD, and Nelson Marques, MD, has also received the Benjamin F. Boy Humanitarian Award. This award is offered by PAAO and recognizes significant participation in charitable activities, indigent care, community service and other humanitarian activities.

J. Bradley Randleman, MD, has been named the editor-in-chief of the Journal of Refractive Surgery. Dr. Randleman is associate professor of ophthalmology at Emory Eye Center at Emory University.

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Who’s in the News

Glenn C. Cockerham, MD, and Gregory L. Goodrich, PhD, were interviewed in November by San Francisco’s KQED-TV for a blog on the variety of vision-related injuries that go undetected in soldiers fighting in Iraq.

Dr. Goodrich noted that one reason many vision problems go undiagnosed is that soldiers often do not realize they have been injured at all.

“Blasts from improvised explosive devices have this huge pressure wave that comes from them,” explained Dr. Goodrich, “and the pressure wave does some rather unique things.” For example, just being near a blast can, in some cases, be enough to sustain brain injury, including vision problems. Dr. Cockerham added, “If you just ask these soldiers how they’re doing, they’ll say, ‘I’m doing fine.’ But if you ask specific questions, and you compare them to other people, they’re not doing so well.”

Dr. Goodrich estimated that at least 6,000 veterans have suffered visual damage as a result of brain injury. “Because some of these are very subtle,” he said, “we don’t catch them as often as we would like to.”

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Passages

J. Lawton Smith, MD, died Jan. 10. He was 81.

One of the “Founding Five” of the Bascom Palmer Eye Institute, Dr. Smith is credited with building the institute’s neuro-ophthalmology program during his 31-year tenure.

Raised in a family of physicians in Greenville, S.C., Dr. Smith attended college at Emory University and medical school at Duke University. He completed his residency at Wilmer Eye Institute at Johns Hopkins and his fellowship at Massachusetts Eye and Ear at Harvard Medical School. He founded the Christian Ophthalmology Society in 1977 and served as its president until 1990. In 1978, he launched the Journal of Clinical Neuro-Ophthalmology.

Dr. Smith considered teaching his greatest contribution to medicine and mentored more than 50 neuro-ophthalmology fellows and hundreds of residents and medical students.

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D.C. REPORT 

D.C. REPORT : New Congress Presents Challenges

With a new Congress seated, the Academy and other physician groups are poised to address key health care reform issues that impact practices and patient access to care. Many House members were elected on a platform of curbing government spending and reducing the deficit, and they have only two years to deliver on their promises. In addition, President Obama’s reelection campaign has begun, and he must work with Republicans to succeed.

The political landscape. The Obama administration and congressional leaders will be focusing on legislative activities related to jobs and the economy. With a growing number of state economies in crisis, physicians are a target for payment cuts and implementation of health care provider taxes. To defend against these threats, the AMA has completed a project that documents physicians’ positive and significant impact on the economy, including providing jobs and spending in the community. Recent data demonstrate that—by all measures—physicians and their practices have a greater impact on the economy than do hospitals.

United surgical agenda is set. While immediate pressure for a sustainable growth rate solution is somewhat relieved by the one-year fix that passed last December, the push is on for a permanent fix by the end of the year. In addition to fixing Medicare physician pay, the Academy joins the American College of Surgeons in a united surgical agenda that includes:

  • repeal or significant modifications of the Independent Payment Advisory Board to ensure physician and congressional input,
     
  • passage of the Health Care Truth and Transparency Act to empower patients by mandating that practitioners disclose their license/training,
     
  • development and recognition of evidence-based guidelines and quality measures to address concerns about utilization increases, and
     
  • elimination or pushback on multiple penalties scheduled for physicians.

Shift in focus for health care reform. The first phase of the health care reform law focused on implementation of insurance reforms and coverage access for vulnerable populations. The Obama administration now moves to the second phase, with two central areas of emphasis—working with the states to establish health insurance exchanges and implementing delivery system reforms that, over time, are intended to reduce health care costs. The surgical community will work together with the new Congress to ensure that the best interests of physicians and their patients are addressed as the focus shifts.

The surgical community is working with the new Congress to ensure that the best interests of physicians and their patients are addressed as the focus shifts on health care reform.

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